MARION NESTLE: INTERVIEW WITH MARK HEGSTED



MARION NESTLE: INTERVIEW WITH MARK HEGSTED

Westwood, MA, September 7, 2005

Note from Marion Nestle: I ran into Mark Hegsted at the FASEB meetings in San Diego in April 2005 and told him that I wanted to interview him about his role in the dietary guidelines. Eventually, we set a time and I went up to Boston and met him at his home. What follows is a lightly edited transcript of the tape.

Marion Nestle

Paulette Goddard Professor of Nutrition, Food Studies, and Public Health

New York University

35 W 4th Street, 12th Floor

New York, NY 10012-1172

marion.nestle@nyu.edu

MN: I thought what we would discuss your recent piece in the Annual Review of Nutrition, which I thought was excellent. In it, you said that you didn’t have the time or space to talk about what had happened around the time of the Dietary Goals and Guidelines. That’s the period that I’m really interested in. In reading your piece, it seemed to me that what was so interesting about your career is that you were right there at the cusp of the transition from vitamin deficiencies to chronic diseases. I’ve heard conflicting views about what happened during that period and I thought we should talk about that. For example, what was the American Heart Association doing during the 1950s. Some people say that heart disease rates skyrocketed after the Second World War, but others say they didn’t. Why don’t we start with what was going on with heart disease and then move forward to the transition from vitamin deficiencies to chronic diseases.

MH: Well, my interpretation is that partly for unknown reasons, the vitamin deficiencies essentially disappeared after the world war.

MN: Was it because people were richer?

MH: Well, I think mostly, undoubtedly that was the case. But I think transportation was probably as important as anything. They [in the Philippines] were going to fortify rice for years and years and they never did succeed. Then after the war, beri-beri essentially disappeared from the Philippines.

MN: Without fortification?

MH: Without fortification. That was the same in our south, you know.

MN: But the diet. Fatback?

MH: And corn and molasses.

MN: The three Ms – maize, molasses, and whatever the third one was – meat.

MH: [Transportation] brings in foods from various other places. You know, it’s like fluoridation. It was a tough time for nutrition. I used to teach during that era. Protein-calorie malnutrition and obesity saved nutrition from…

MN: …from disappearing as a field.

MH: Completely! And the epidemiology of heart disease…you know, I think my paper was better than anything. Cholesterol!!

MN: You say so quite clearly!

MH: [Shows a coffee mug with the Hegsted cholesterol equation on it]. The Keys’ equation is two in one, 2S [saturated] minus 1P [polyunsaturated]. It was so simple that everybody could remember it. But you know, if he had put in cholesterol, the saturated fats would have gone down. Then, I don’t remember when that was- I guess the early 70s—came the the nutrition committee. Fred Stare was on it. But you know that a cardiologist in general knows nothing about epidemiology. That recommendation went to the McGovern committee. They did a lot of stuff. They do a lot of checks to see if it would work.

MN: Let’s talk about the McGovern committee.

MH: They had hearing after hearing about anything having to do with nutrition that you can think of, almost. Everybody in business and academia and government testified. They put enough money into nutrition that they ran out of scope. They couldn’t get more money, so there wasn’t anything else they could do. I knew some of the fellows on McGovern’s staff and one of them was a former student of mine.

MN: Who was that? Was that Nick Mottern?

MH: Nick Mottern- he was on the staff, but –

MN: He was not your student.

MH: He wrote the Dietary Goals for Americans. And he came to see me, and I don’t know- it turned around. What happened was that because they weren’t going to get more money for malnutrition, they held the hearings on killer diseases. I testified. He testified. It was all about sugars.

MN: Let me go back just for a second. If they weren’t going to get any money for malnutrition because it had already been spent, they were…

MH: The programs were getting too big!

MN: The WIC program?

MH: WIC, School Lunch, Food Stamps.

MN: The whole works.

MH: I don’t know. All of them. And I’m quite sure that they were convinced they didn’t know what more to do in that area. So if they didn’t have more to do, they were going to go out of business. So the staff, I think, dreamed up-

MN: Dreamed up the idea…

MH: …these hearings on the killer diseases. And, from that testimony, Nick Motterm really wrote the Dietary Goals for Americans. And he came to see me--I guess it was in June [1977]. And it’s not a very good publication.

MN: This was the original one [February 1977]? The one that came out earlier in the year?

MH: Well, even the one that came out [later in December] isn’t very good. He was sort of scraping the bottom – you know, Nick Mottern is a bit scary.

MN: I don’t know anything about him at all.

MH: I didn’t know it at the time, but he is a vegetarian.

MN: So there was an underlying anti-meat agenda.

MH: There was an underlying interest in this. But at this time he came to see me with his drafts. They announced that the McGovern committee was going to disappear. And my first suggestion would have been, well, send this to the Food and Nutrition Board. They’re the experts. But obviously, they didn’t have time to do that. [It would take] at least a year or more and the committee was going to be disbanded the next January, I think.

MN: In any case, wasn’t the Food and Nutrition Board conservative at that time? I mean, these are the people that…

MH: Well, maybe I was naïve because when it [the Dietary Goals report] was published, I tried to edit it, taking out what I thought were the main… [flaws].

MN: Where were you at this point?

MH: I was here at Harvard. And I took out what I thought were the least desirable parts of the manuscript. And then it was published. I don’t have a copy of the first edition.

MN: I do.

MH: The first one?

MN: Shelly [Sheldon Margen] gave me his copy.

MH: One of the recommendations was “eat less meat.” Well, obviously, there were people like Dole and others who were from farm states who didn’t like that very much. And again, I don’t remember exactly why the committee [chose] to revise the thing and then it was published as the Dietary Goals--the second one.

MN: There was a bit of a fuss in between.

MH: Yeah, there was fuss. Well, everybody fussed. The nutrition societies were aghast that a bunch of politicians would put out this kind of a publication. Anyway, over Nick’s objection, I said that I thought we should take out “eat less meat”. There wasn’t really any support for it other than the fact that meat was high in saturated fat. So then that [the second edition] was published. Well, then the Food and Nutrition Board at the Academy…the president of the academy, a biochemist from Duke...

MN: Was it Isselbacher?

MH: No, he’s a gastroenterologist. Anyway, you’ll find that in the notes. He told me that the Food and Nutrition Board would never support that kind of nonsense. Sure enough, the Food and Nutrition Board--about half the members already said they were opposed, about 4 or 5. Well, right at that stage, the influence came from McGovern, who was head of the Agriculture Committee. I think he was satisfied with what was going on and [thought] that nutrition [should] be elevated to a more important position in agriculture, and that [the USDA] should be the primary government agency to deal with nutrition except for clinical nutrition.

MN: So this was the famous report language that gave the USDA lead agency responsibility for nutrition and dietary guidance?

MH: Well, it didn’t seem to make much sense [to leave it in HEW] because the budget for nutrition- I can’t remember what it was – was miniscule compared to the money of NIH.

MN: And HEW didn’t object?

MH: Well, I don’t know whether they objected, but it was in the Farm bill, and it was too late to object. Whoever was head of the Institute at that time testified before McGovern and the Agriculture Committee that he didn’t think the NIH should take a position on [dietary guidance]. They conducted research. I think that’s one of the reasons that [the lead agency provision] got put into the Farm bill. Agriculture was damn little interested in nutrition, but now it had to do something to elevate nutrition. Someone on the McGovern committee staff suggested I apply for that job.

MN: The one whose name you can’t remember.

MH: Yeah.

MN: Okay. It will come. We’ll look it up.

MH: And we can look it up. Well, I was getting near retirement. Another one said “why didn’t you apply for that job?” And I said, “I did!” But they lost my application. But then it surfaced and I went down and got the secretary and –

MN: Who was secretary then? Do you remember? I don’t. Never mind. On you go.

MH: I couldn’t remember either and I looked it up on the Internet. [Jimmy Carter appointed Bob Bergland as USDA Secretary in January 1977] But he was the one that said they would confirm the Dietary Guidelines over his dead body. The week I was there, somebody had organized this big committee meeting at the NIH. There must have been at least 50 people. The first question the agency asked was what is the government’s response to the Dietary Goals? I argued that we had plenty of expertise to do the job ourselves. I said the Food and Nutrition Board makes recommendations--they don’t implement anything.

MN: They didn’t do any of them? Was Mike McGinnis involved?

MH: No, McGinnis was not involved at that specific time.

MN: We are still talking 1978 here, right? What was the title of your job at USDA?

MH: I was Administrator of Human Nutrition.

MN: Reporting to Carol Tucker Foreman?

MH: No, reporting- no, I was reporting to the assistants secretary on the education side. Well, anyway, this committee met 2 or 3 times and they said, “If we’re going to do this, we’ve got to review the literature.” And I said, “You know, that’s been done half a dozen times.” None of us were willing to undertake a job like that with 200,000, 100,000 references.

MN: A big job even then.

MH: And we were aware that the American Society of Clinical Nutrition had a committee that was to deal with this [the research review].

MN: This was the Six Factors committee?

MH: The who?

MN: Oh, the committee that reviewed the research on six dietary factors [the report came out as a supplement to the Am J Clin Nutr in 1979;32(12)2621-2748].

MH: Anyway, we agreed we’d have to rely on that report.

MN: This is the one where they voted on the strength of the evidence?

MH: They voted on – I don’t know, it was only six or maybe more, the

strength of the evidence that linked saturated fat and a whole bunch of different factors. With only 8 or 9 people on [our] committee, the committee decided, well, we’ll have to rely on that report. But then after it [the Six Factor report] came out, again I’m not clear exactly why, we decided that it had supported the Dietary Goals.

MN: As I remember it, it did.

MH: Statistically I guess it did, but, right on the borderline for most of it. So somebody found some woman whose name I don’t remember to write what eventually became the Dietary Guidelines. But then, McGinnis got involved and her reports came to me and then they went to McGinnis. They went out to NIH to see whats her name?

MN: Artemis Simopoulis?

MH: Simopoulis. And I guess they went around 3 or 4 times and finally McGinnis and I simply…

MN: …there was an intermediate report, I think in 1979. The USDA put out a new food guide, the “Hassle-Free Guide.” This was before the guidelines. That was the one where the vegetable group was on top and then the fruits and then meat and dairy products. They were in a stack.

MH: Was it a pyramid?

MN: No, it was a stack. There was a huge uproar over it because it had vegetables on top, and meat at the bottom.

MH: The title of it sounds right to me, but ’79 seems too soon. We didn’t get it done that fast.

MN: Maybe it came from another section of USDA?

MH: Once the Guidelines were published, then I asked the women out at dietary surveys to come up with some kind of descriptive or something to support the guidelines and that’s how they eventually came up with the food pyramid.

MN: Wasn’t that quite a bit later?

MH: I understand that was quite a lot later.

MN: The guidelines pamphlet that came out in 1980 was very simple.

MH: That’s right. That was the-

MN: Wayne Calloway told me that he was responsible.

MH: Who?

MN: Wayne Calloway. That he was responsible for getting out the guidelines. He was working for McGinnis.

MH: Well, I guess I do remember talking to him, but I can remember specifically when McGinnis and I got together and said, you know, this is adequate. We’re ready to publish this. He [Calloway] may have shepherded this thing through to McGinnis.

MN: There was no particular fight over the guidelines?

MH: No, I helped them and they didn’t object to this. The Surgeon General was from Harvard [Julius Richmond]. The Secretary of Health was a woman. A black woman, I think [Patricia Harris]. Isn’t that right? And I don’t recall any real opposition on the health side. And, I must say, well, obviously, things never would have gone through without Carol [Tucker] Foreman.

MN: I mean, you didn’t have to go through entire department clearances?

MH: I didn’t have to go through her.

MN: You didn’t have to go through her, but what about Department clearances?

MH: Well, the secretary is in the picture in there on my wall, a former representative from Minnesota [Bob Bergland]. I don’t think any Secretary of Agriculture before or since would approve of the Dietary Guidelines. I’m sure there must have been opposition in the department, but it never got them stopped.

MN: And so somebody was hired to write them?

MH: Yeah. I don’t know who that was.

MN: Somebody wrote them and it went through the Departments?

MH: I say it went through me, it went to McGinness and to NIH where Simopoulis was the primary person and I think it went 3 or 4 times as it gradually developed.

MN: Was Esther Peterson there at the time?

MH: Yes.

MN: She once pointed out the inflammatory red 3 [the saturated fat guideline] in the 1980 edition.

MH: The only time I can really remember meeting her was with the group that is still down there—Center for Science in the Public Interest?

MN: Yes.

MH: They gave a party for me one time and Esther Peterson was there.

MN: So she wasn’t involved in writing the Dietary Guidelines?

MH: I don’t think so. I don’t really know what happened at Health and Human Services or at NIH, except that these drafts keep going around and coming over my desk, everybody chipping in a little. When they were published, you know they had a meeting where they presented it to the public--what do you call that?

MN: A press conference?

MH: Yeah. And who worked for the NY Times then, what’s her name?

MN: Marian Burros?

MH: Marian Burros and…

MN: Jane Brody?

MH: Jane Brody was there. Jane…said “That’s a lousy publication!” “There’s no science to it,” she said. And the secretary was a little uneasy because he said, “You know, you’re recommending this for everybody.” And I said, “well that’s the nature of public health.”

MN: Now when they came out, had Reagan already been elected?

MH: No.

MN: They came out before the election?

MH: Just before. I’m not sure when the Food and Nutrition Board published Toward Healthful Diets, I think it was called [early 1980s].

MN: Let’s just do this first. When the Guidelines came out, Reagan had already been elected but hadn’t taken office. All hell broke loose, no?

MH: Well, it shouldn’t be that all hell broke loose. I think that was before Reagan was elected. Certainly, the Secretary of Agriculture had a press conference when he presented them to the press. So that had to be while he was still Secretary.

MN: And the reaction to it?

MH: Oh, hell, anybody would agree. I don’t know who the hell agreed, but I never heard of who they were because, frankly, all the comments I heard were negative. Although some students at Harvard wrote me a note saying that they agreed with the Dietary Guidelines. But then, you know, everybody began to come around after a while.

MN: They were pretty benign.

MH: Sure, they were common sense. That’s essentially all they were.

MN: But there was the problem of the red #3 at the centerfold [eat less saturated fat].

MH: Well, you know, I think they must have come out maybe a year before Reagan was elected because I remember the egg people came to see me, with a lawyer.

MN: With a lawyer?

MH: And when they left, the lawyer looks me in the eye and says, “Well, we’ll be back.” You know, I didn’t know whether the department would defend me if they [the egg people] sued me.

MN: They didn’t like the cholesterol recommendation?

MH: They certainly didn’t. And the “porkettes” came to see me.

MN: The porkettes?

MH: Disguised as pork!

MN: Porkettes?

MH: And they said, “You know, this [pork] is a low-fat meat!” and I said, “You just have to take advantage of whatever you can find. I can’ t recommend pork.” I didn’t hear opposition within the department. You know, the side I was on was ARS.

MN: The education side.

MH: The science [research] side, presumably. I don’t really recall if any of those people objected to these, or maybe they just didn’t say anything.

MN: So you didn’t feel that there were any personal attacks on you?

MH: Only from the Food and Nutrition Board part of the academy. I thought those bastards were out to get me.

MN: How was that manifested?

MH: Well, as I told you, I had this meeting with them. They said “I’m never going to support that kind of nonsense.”

MN: Who said that?

MH: The president of the academy.

MN: The president of the academy?

MH: Phil Handler.

MH: Well, you know, then we had hearings in the house and hearings in the senate committees. This senator was from Iowa [Thomas Eagleton]. He was the one who was supposed to run with McGovern and dropped out, when they said he had mental treatments.

MN: Ah, yes.

MH: Phil Handler and Bob Olson both testified against us. And they kept going and going and going. It must have been 4:30. Carole Foreman and I and my boss were there. You know, it must have been 4:30 in the afternoon and then he didn’t want to hear what we had to say. So I guess that’s the history. One other story I have to tell you. This was after the Dietary Goals were published that the committee again held hearings for a lot of the opposition. I was there in the afternoon and Dole was the only one on the committee who was left. Finally he got up and said, “Look, I’ve done this for you and that for you. If you’re going to object to that, I’m not sure I want to represent you anymore.”

MN: He represented you?

MH: Well, he was from Kansas and that’s what he was pointing out. I don’t know what he had done, but he named 3 or 4 things and said, “If you’re going to oppose me now, I don’t know if I want to represent you.” I thought that was about as good a statement from a senator that I had heard. But you know, the next thing I remember was that after Reagan came in, he appointed a committee to evaluate the Dietary Guidelines. Or re-do them. My guess was that they were going to practically do away with them. Fred Stare was on that committee and, you know, he opposed me at every step. His girlfriend in New York--whatever her name is--testified at least twice against the Dietary Guidelines.

MN: Fred Stare had a girlfriend in New York? Oh! Not really his girlfriend. You must mean Elizabeth Whalen [of the American Council on Science and Health].

MH: His girlfriend.

MN: Was she?

MH: Oh, I don’t think seriously.

MN: Not romantically, just soul mates?

MH: Hmm?

MN: Soul mates?

MH: Yeah. But the strong supporter was the guy from the Heart Institute.

MN: But at some point the Dietary Guidelines came out, Reagan was elected, and in between the time that Reagan was elected and Reagan was inaugurated, things must have been fairly uncomfortable at the USDA, no? Or did they just go on with business as usual? What happened on January 20th when Reagan came in? What happened to you?

MH: Well, it took a little time, of course, before they kicked everybody out.

MN: Well, first of all, explain what your position was. You were not a political appointment? You were in the Senior Executive Service or something?

MH: Yeah, Senior Executive Service. You know Carole Foreman said that originally she thought I should be in a political appointment, but somebody convinced her otherwise. That was the correct decision. But, what was I going…

MN: …You were talking about?

MH: The you-know- the Foundation …

MN: What did it do?

MH: Well, the head of it was one of the first guys to work on tobacco and cancer.

MN: Aha. The American Health Foundation. Ernst Wynder.

MH: Wynder.

MN: At the American Health Foundation.

MH: You know they gave me an award.

MN: Did they?

MH: After the new [USDA] Secretary came in. They put a demerit on my record for accepting the award.

MN: For accepting it?

MH: That was even though I had told my boss about it. My boss was still there when they did this because he came and told me.

MN: I see.

MH: He hadn’t been replaced yet. So I don’t know how long it took.

MN: How long did it take before you were replaced? What did they do? They eliminated your job or some such thing?

MH: Well, they did that. I really don’t know, but shortly after they came in as I told you, they didn’t fire me. You know, you can get rid of people by doing that but…

MN: You had this office up in the Department of Agriculture where you did nothing?

MH: And I remember, somebody from the staff came around and showed me my official…

MN: Demerit?

MH: Duties.

MN: Oh. Your duties. And they were?

MH: Job description.

MN: And they were to do what?

MH: Well unfortunately I didn’t get a copy of them. You would have thought everybody from Reagan on down would have been knocking on my door.

MN: You were science advisor or some such thing.

MH: I couldn’t figure out what the hell to do. There was another fellow there who this had happened to years before and he spent the year or two out in the library in Beltsville with the agriculture group out there. But they were right on the Secretary every day; they wanted to know where I was. There’s no doubt about that.

MN: They were worried that you were out causing trouble?

MH: Well, I suppose. Well, you know what I should have done. I should have gone to the press and told them what happened to me.

MN: But there were some things in the press. Science Magazine wrote about it.

MH: … I don’t know. Were there? But nowadays if something like that happened, that someone was put on the shelf and he’s paid a good salary…but I didn’t think anything got in the news about it.

MN: No, I didn’t see anything about that part of it.

MH: But I think in retrospect it wouldn’t have helped any, but it would have made me feel a little better. Because I think that if it happened more recently that people got shelved like that, they would be criticized for making money. Well now you know. All these years later, they’ve [the Dietary Guidelines] been revised I don’t know how many times and they’re still pretty much the way we wrote them.

MN: They’ve gotten more complicated.

MH: Yeah, unfortunately they get more and more complicated. Well these last ones… I think it’s absolutely ridiculous. Doesn’t make any sense to me. 93 pages.

MN: 70. Don’t exaggerate now.

MH: Most of it doesn’t make any sense. I figure they’ve done the same things the Food and Nutrtion Board did. The standards [DRIs] are so screwed that up that nobody can use them. You know, the answer is so simple. You put all of this on a calorie basis. You just need one figure. So many grams, milligrams, or whatever per thousand calories. And that’s as good as you can do. People eat less because they need less. And they’ve got this damn complicated business of how to calculate for differences in size and calorie intake. It’s absolutely ridiculous.

MN: Well, the way it’s working now is that the DRIs are the basis of the Guidelines and the Guidelines are the basis of the Pyramid. And you need six fat volumes to explain the DRIs.

MH: Well, I suppose that the DRI or whatever the figure is that most people just take it as is. Don’t you think?

MN: The DRIs?

MH: The same way as they did the RDAs before.

MN: I find them incomprehensible. You can’t understand them and you can’t teach them.

MH: That’s right. You can’t.

MN: Try teaching them. It’s really hard.

MH: When I was in Washington the dietary allowance committee was meeting. Garth Hanson proposed putting in dietary density recommendations. But nobody would accept it. I think at that time if we had accepted them maybe it would have changed the direction. I’m convinced that’s the only sensible recommendation to make now.

MN: I think the problem is that so few people think critically about these standards.

MH: That’s the job of the Academy, for God’s sakes.

MN: You would think so. But the science isn’t there to back them up.

MH: No. You know these are a best guess. Even at best. Some vitamin A in your diet doesn’t get absorbed. Yet you discuss it down to the last detail.

MN: So where do you think nutrition is going?

MH: I guess I’m glad I’m out of it because I just don’t see it. A lot of people think now that they have genetics, they’re going to have dietary standards for every individual. But even if you do that, it wouldn’t be very useful except for a few people. Even if you could set standards for age and weight and activity and sex, you’ll never be able to do it.

MN: So maybe the story is the same one that you started with. This is a profession looking for something to do?

MH: Well, right after the war, I think we were looking for something to do. What’s around the corner…

MN: Well, one of the things that strikes me is that the closer we look at nutrition, the less it has to do with nutrients. Vitamins have something to do with health--without question. But with these chronic diseases, the role of nutrition is hard to define.

MH: Well, I think one of the bright spots right now is vitamin D.

MN: Yes?

MH: You know, it’s a hell of a lot more important than we thought it was. I gather now, the experts say between 2,000 and 4,000 units.

MN: As long as you don’t get it from the sun because you’re wearing sunscreen.

MH: If you get it from the sun you’ve got to be careful. (?) But, Mike Holick knows more about vitamin D than almost anyone and he had an appointment in dermatology. And they fired him. That’s one development that’s interesting. I think the Dietary Guidelines are what people should do. Don’t you think? Reduce your fat and cholesterol and so on.

MN: So is that good advice?

MH: The trouble with them is they’re too simple. To teach moderation is very very difficult.

MN: What about food companies?

MH: Food companies? I never had a-

MN: Did you ever work for a food company?

MH: No.

MN: Consult?

MH: No, I-. You know the Monell Insitute? I was on their board for a number of years. After I got acquainted with them, they took me out to Campbell’s to meet the president. I thought that was fine. He (unnamed) took me down the hall and they had all these executives lined up around the table. And he said, “You know, we’ve spent millions producing a low-sodium soup, and nobody will buy it. What’s the matter?” I said, “I guess you can’t make a good low-sodium soup.”

MN: I worked for the Federal Trade Commission in a case against Campbell’s once. That was Campbell’s argument. If they took the sodium out of the soup, nobody would buy it—or so they said.

MH: Iin some foods it’s a lot tougher than with others.

MN: People do like their salt water.

MH: They produce a low-sodium soup in our cafeteria.

MN: Oh, do they?

MH: Every day. Most people buy it now too.

MN: I worry that nutrition is moving away from public health and toward individual recommendations. And the public is desperately confused. Or so I hear constantly.

MH: That’s a shame. I hadn’t thought much about that. But I have thought that the trouble with the Dietary Guidelines is that they’re just too simple.

MN: People don’t like simplicity.

MH: Well, everybody knows it so what are you going to teach?

MN: But the food industry’s response to the Guidelines is so fierce.

MH: Well I remember meeting with the food industry. I remember saying to them, “the dietary guidelines have created more opportunity for you guys than anything that’s come around in a long, long time.” You know, we did say “eat less sugar.” There are [other] things we should have done. We should have included white bread in with the white sugar. If they had come out two years later, we would have said, fish--include some fish.

MN: Walter Willett puts potatoes in with the sugar.

MH: Well, I, you know, what do you call the glucose tolerance thing?

MN: Glycemic index?

MH: Glycemic index. I suppose that has some validity. I don’t know an awful lot about that but it’s a limitation that ought to be more widely recognized. Potatoes and white bread.

MN: But it’s only hot potatoes. If they’re cold, they have a low glycemic index.

MH: If they’re cold?

MN: That’s my favorite example.

MH: I didn’t know that. Well, this obesity business is something. When Camilla is here with the baby we often go to a Chinese restaurant, but there’s a toy store next door, so when we go the Chinese restaurant, she says “I go to the toy store.”

MN: Good for her.

MH: But the toy store was closed. We were too late. So then we went to another toy store, and she suggested another restaurant up there that’s an ice-cream place. But they have a little dining room about as big as these two rooms and I ordered a hamburger but I thought, “boy, this place is just a typical bad part of the restaurant business.” Here comes this hamburger, it’s that big around and that high, and I think I ordered cole slaw that comes in a tub like this and I looked around at people and about half of them are overweight. It’s just a good example of what’s wrong with the food industry these days. There’s just too much food. Food is too cheap. There’s an advantage apparently in limiting size of servings.

MN: People love big servings.

MH: Yeah, people like to eat. When I first came to this place, I thought the servings were fairly reasonable. Now I think they’re large. People here [in the complex where Hegsted lives]. These are the survivors. My neighbor (?) is 97. I wouldn’t say she’s obese, but she’ pretty chunky.

MN: Probably that’s what’s keeping her enjoying 97.

MH: If you want to know anything, you go see Priscilla. She knows about everybody.

MN: How does she do that?

MH: Damned if I know how she does it. She plays bridge a couple or three times a week, I suppose. That’s where the gossip comes.

MN: It sounds to me like you’re still reading the research literature. Are you still keeping up with the literature?

MH: Oh, I wouldn’t say I keep up. I look at the titles of the nutrition journals and I buy Science, and that’s the limit. But I must admit, it’s rare that I see an article that I read the whole thing.

MN: You were at the FASEB meetings, so you must have listened to some of that.

MH: Well, the trouble is that I don’t hear well enough. And I don’t see well enough. So, I go to see my friends, about 40 people there that I still know, at least. I would say 20 to 30 and some of them bring their wives. But I rarely go to meetings.

MN: You can’t keep up with the PowerPoint?

MH: My problem is word recognition. I can hear, but I don’t understand. Talking to someone, I get along quite well with people talking across the table. You don’t know whether you read lips or what it is. If you know what the conversation is about…

MN: Makes it a lot easier. You’re not going to write memoirs, huh?

MH: Well, I don’t know. Probably not. You know I wrote 20 pages of my early life. Well, you know, my grandfather was a Mormon convert in Denmark. And his first wife was the aunt of the guy who had the black seeds and the black little sculptures. And my grandmother…well, my grandfather brought a load of Mormons--a shipload of Mormons over--and one of them my grandmother. They walked from Missouri to Salt Lake City fighting the Indians, and he had three wives at the same time, 27 kids. None of them wrote anything about anything. There’s a little book my grandfather wrote in. Stupid. Today I went to see so-and-so, next day I went to see somebody else, and I preached this. My grandmother--she used to tell us stories about walking across the plains and fighting the Indians. The Indians stole a woman. They never found her.

MN: And none of them took notes.

MH: My first years I have described adequately for the family. Other than that, I don’t know.

MN: The scientific years, you wrote about, I thought, very eloquently in that piece. Very nicely done.

MH: Expand on that.

MN: The impression that I’m got is that the business with the USDA ended up being quite painful.

MH: Well, in a way it did, although I had a ball when things were going well. I know that you were disappointed when you got there, but I had a ball.

MN: Oh, I had a really rough time [editing the Surgeon General’s Report on Nutrition and Health from 1986-1988].

MH: I say you have to be at a high enough level to make a difference. And all the people around Beltsville, for example, were essentially ignored until I got down there and then they came up one level. They came out to meetings and parties and so on. As soon as I left, there’s one person in ARS who sort of communicates plans from the central office out. He thinks it’s a know-nothing job. He’s got a son who runs the USDA lab in North Dakota.

MN: Gerry Combs?

MH: That’s right. And I said, “Gee, I think it’s a know-nothing job. No authority. How do I do it?”

MN: Well, he retired right after the crisis over the first Pyramid. And then he talked.

MH: If you’ve been in government as long as Gerry, of course, you want to stay there. In fact, that’s the biggest mistake I made, you know. I should have had them transfer me to Tufts.

MN: Ah yes.

MH: I didn’t really want to be working under…

MN: Irv Rosenberg?

MH: No.

MN: Oh. Jean Mayer?

MH: No. The guy from MIT. The Scotsman.

MN: Oh yes. [Hamish Munro]

MH: I’m one of his great admirers, so they offered me a job out at the primate center, and that wasn’t very successful. They don’t do any nutrition studies out there, except for one pretty substantial project. There’s one marmoset species that gets cancer of the colon and we set up a study of one diet that had high levels of all the cancer preventive vitamin E and selenium [compared to] regular chow. And we thought it would be to our advantage to get Kurt Isselbacher involved because he was the head of gastroenterology at Mass General. The second year, we had to raise babies and put them on various diets. Just when the babies were getting to an age where they were interesting. Kurt really cut this down. He changed the objectives of the second application.

MN: In the middle of the study?

MH: Yup. When we reapplied, I can’t remember exactly what they were interested in but it obviously had nothing to do with the monkeys. And shortly that study was terminated. This wasted a whole bunch of time and effort. What I should have done when I was out there was what they’re doing in Wisconsin--putting animals on a restricted-calorie intake, an aging study.

MN: You think there’s anything to that?

MH: Oh I’m sure there’s something to that. You know, that’s a treatment that’s worse than the disease. But there’s an article in the last Harvard magazine, “Is Aging Necessary?”

MN: “Is Aging Necessary?”

MH: Maybe diet restriction works.

MN: People like being kept at 80% of their body weight?

MH: Oh no hell, it’s an impossible treatment, but it’s true.

MN: People live longer?

MH: Well, not people. Every species.

MN: Animals, yes.

MH: Everything from fruit flies. It’s beginning to look as though it’s true in monkeys. There’s something there to be found out about how that works.

MN: I just read interviews with people who participated in Keys’ starvation studies during the second World War.

MH: I saw that. Where was that? Was that in the Atlantic?

MN: I thought that was interesting.

MH: That’s a hell of an experience, I’m sure.

MN: It’s an amazing study. I was looking at it not too long ago. You can’t do anything like that anymore either.

MH: Oh hell, even our studies would be illegal. Dietary studies on serum lipids would be too. You have to do them outside the United States.

MN: There’s lots of fuss about that too.

MH: Well it’s a little too bad in a way because, you know, what we did to our people in Danvers was the best thing that happened to those guys.

MN: Now this was which?

MH: The guys that participated in the lipid study. They were in the Danvers hospital. You had to have a cook there for each meal. We had a dietitian almost all the time. The food was better. Tender-loving care. You know after the first study that started in the fall and ended the next July, we shut it down for a month or two. And then about half of them just went home.

MN: They thought it was more fun then you did?

MH: Well it was-tender loving care and paying attention to these poor guys.

MN: What were they?

MH: Calcium studies.

MN: Ah, the calcium studies.

MH: Which is also one of the better papers.

MN: That’s a very funny anecdote. This is when you were working with all of these murderers.

MH: That’s right, but we had several of the world’s most famous murderers, but when we closed that down, gee, they were crying on our shoulders. That was the best thing that ever happened to those guys. A couple of pretty girls doing the meals and talking to them. But that obviously would be illegal now.

MN: It’s interesting that the Food and Nutrition Board mentions your calcium studies in the DRIs but ignores them.

MH: Look at the epidemiologic evidence.

MN: Also not taken seriously.

MH: I still like that quote I used in that article. Do you remember it? Cows on their low-calcium diets.

MN: I used the line, “cows don’t drink milk” in talking to a reporter. I got a ton of e-mail messages from people who said “You idiot, of course cows drink milk. How do you think calves survive?” And the Center for Consumer Freedom said “What does she know, she’s a city girl.” I answered them saying, “Hey what do I know. I thought there was a difference between a cow and a calf.” But, I didn’t realize I plagiarized the quote it from you. I’m sorry.

MN: Why do you suppose the calcium epidemiology is ignored?

MH: Well, the dairy industry-

MN: Bless them.

MH: Beginning really with the nutrition guy from Wisconsin who essentially established the dairy council. And the famous nutritionist at Columbia Teacher’s College published studies of low-calcium diets that produced malformations. The Dairy Council, you know, they dominated nutrition for…

MN: Still do.

MH: Still do. That’s right. The RDAs were based primarily on the studies in Illinois. The study said dietary requirements are variable. That’s one of the things I missed completely—recognizing that that balance studies never determine requirements.

MN: Why is that?

MH: Because they reflect the diet that the person is eating. Vernon Young studied amino acid requirements in balance studies that measured what you need to maintain metabolic turnover. That’s what he did. He measured the amount of amino acid it takes to maintain metabolic status of people eating an American diet. You ought to look them up. He wrote a couple of books. But he had Yale athletes and soldiers on a low-protein diet--low, but all essentially all vegetarian. You have to stabilize somebody on a diet.

MN: When I was teaching medical students about parenteral nutrition, everyone said you had to have balance studies.

MH: I did it right on my calcium studies, but other than that, everybody treated the data incorrectly. The output against balance--you know you’re correlating one thing with itself. You have the same intake at both sides and so-

MN: It should correlate quite well.

MH: Yeah they do correlate. You pick out random numbers, and they’re correlate at about .4 or .5. Highly significant. Some guy in England wrote a paper a while back about that.

MN: That’s like the validation studies of food frequency questionnaires 0.4 or 0.5 correlations.

MH: I guess it’s too late now, but I knew that way back after I did those studies in Peru and for some reason we did some nitrogen-balance studies in Peru after I did the calcium-balance studies. I just can’t understand why I didn’t…

MN: Well, because protein and calorie malnutrition…

MH: Respond to the way I…

MN: Protein-calorie malnutrition is one of the reasons why nutritionists existed. You can’t make it go away. The new Dietary Guidelines and Pyramid recommend 3 servings a day of dairy foods instead of 2. Why? Because of potassium balance. You need a lot of potassium to compensate for all the junk food people are eating.

MH: For all the salt intake.

MN: That’s right.

MH: Well, I must admit I take 250 mg of potassium every day.

MN: Do you? Not too much I hope.

MH: No. In fact, 2 years ago, my blood sample came back and my potassium level was slightly above normal, so I cut back to one tablet. I thought you had to eat bananas to get potassium.

MN: Fruits and vegetables in general—9 servings a day.

MH: You know that’s another thing that sounds preposterous.

MN: It is preposterous. It is. Even if it’s half cups. It’s still 4 ½ cups. Reporters who went on the recommended diet couldn’t do it.

MH: Some of these things … a nutritionist would know that, wouldn’t you?

MN: You would indeed.

MH: I’ve always thought the reason they did that is because the servings are so small. I’m probably doing very well. Last few days for lunch, I’ve had corn and some tomatoes and melon.

MN: Sounds good.

MH: And I probably have a salad and some kind of vegetable for dinner. Still doesn’t make 9 servings. It’s amazing, isn’t it? I remember when I was on the Food and Nutrition Board and the committee published the first recommendations on magnesium . USDA said “you know we can’t make diets that have that amount of magnesium and B6.” All I could say was, “it was only a recommendation.”

MN: Wasn’t there a story about the Dietary Goals where nutritionists put together menus requiring 20 slices of bread, or some such thing?

MH: We didn’t recommend amounts of food. Did we?

MN: I don’t think so.

MH: I don’t remember that. You know the RDAs used to have examples of diets in the back of them.

MN: Oh, is that right? The old editions?

MH: The story was that people thought that was the ideal diet.

MN: We don’t have them now.

MH: Who’s the head of the Food and Nutrition Board now?

MN: Rob Russell from Tufts.

MH: Oh, Bob.

MN: He replaced Cathie Woteki.

MH: What does the Board do these days. Do you have any idea?

MN: I really don’t, although they are producing interesting reports on fish and marketing to children.

MH: That fish one would be useful.

MN: It’s going to be a very good report, I think, from what I’ve seen of it. And then the Canadians funded a summary of the DRIs that will summarize the whole thing in one place. That will be very helpful.

MH: It seems to me, that after all that fuss, the only thing people would pay attention to is one big one.

MN: The figures are divided across so many different age and gender groups, so it’s more complicated.

MH: What are there? … 20 nutrients?

MN: More than that.

MH: Whatever it is, you have 12 or 15 age and sex groups and they multiply. I got out probably at the right time.

MN: Maybe so. It certainly marked a big turning point. After you left, the fights got tougher. Except for that one moment in the late 1980s when the appeared to be consensus.

MH: Maybe. I think it took about two years after the guidelines came out before the nutrition crowd decided they were alright.

MN: Well, there was Toward Healthful Diets in between.

MH: And then the big books.

MN: The big books from the Academy and the one I worked on, the Surgeon General’s Report. It looked liked there was consensus, but that didn’t last long.

MH: No. That was a pretty good report. I remember, I testified--I went down to the committee meeting. I said to the Chairman of the group, “you know, we already published general conclusions.”

MN: Chairman of what group?

MH: I have trouble with names.

MN: I do too.

MH: Everybody apparently does but I’ve always had trouble. My chief lab technician--I never knew her name. That poor gal. amazing story. About three years ago, she got ill. She came to some lectures and I said “you don’t look very well.” “No,” she said, “I’m not feeling very well.” And I invited her out here to dinner with her husband once a year. But they didn’t come. I called and they said, “We’ll be out.” But she died of stomach cancer.

MN: Oh dear.

MH: And never went to see the doctor. She said she was afraid they’d find something wrong with her. But to put it off like that? Sometimes they can give you help.

MN: Well, you promised me two hours and I think that’s about what it’s been.

MH: I guess we’ve about run out of things to say anyway.

MN: Well, I can think of a few more but I’ll save it for another time. And leave it to Henry Blackburn to pick up the rest.

MH: You can come back again.

[End of tape]

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